Karl Deisseroth's 'Projections'

(16 Aug 2021) notes

I missed Karl Deisseroth’s live book discussion at the Harvard Book Store a few months ago. I visited the store yesterday and despite the growing number of half read books in my room, decided to buy ‘Projections’.

The book reminds me of a cross between VS Ramachandran’s reflections on cognition and the self, Atul Gawande’s humanizing interactions with patients, and Desmond Morris’ tentative proposals on the evolutionary bases of human traits. The prose is stylistic, and get dreamy in places to the point of being a little jarring, but I enjoyed the bulk of it.

The book is divided into chapters loosely based on groupings of psychiatric disorders. Having read the 200 odd pages in a single day, I have to say I felt a little spooked by the direct language that Deisseroth uses to describe the disturbing clinical symptoms and behaviors. Having only heard of Deissoroth for his contributions to optogenetics, I found the book very insightful in the ways that the technology has been used to further our insight of various psychiatric disorders, made relatable by the author’s varied personal experiences.

Some notes and quotations:

  1. “The story of optogenetics demonstrates, …, that the practice of science shouyld not become too translational, or even too biased toward disease-related questions.” (Prologue)
  2. “Words were the only tool for the neurologiest that night”. (Chapter 1) There is a recurring emphasis on words being the only medium by which to share experiences and probe the inner realities of patients.
  3. On quantifying mental state: “We can use rating scales to quantify synmptoms, but even those are just words transformed.” (Chapter 2)
  4. I enjoyed Deisseroth’s insight that the external layer of cells on our skin that separates ‘us’ from the outside also compose our brain, separating, emotionally ‘us’ from the outside. The insight into cutting and self harm clarified a lot of my misunderstanding of these behaviours. (Chapter 4)
  5. “… our shared reality is not real; it is only shared.” (Chapter 5)
  6. The personification of anorexia nervosa and bulimia nervosa from the fragmented mind was particularly haunting. (Chapter 6)
  7. In describing the words of Aynur outgoing the Uighur, and Mr. N, the elderly patient suffering from dementia and depression, and Micah, the anorexic-bulemic patient, the most remarkable thing that stood out was the mental fortitude of the psychiatrist in handling the cases repeatedly, even when the outlook is bleak. Very moving.

I came for the optogenetics, of which there is very little in terms of technical accomplishments beyond the basic description of channelrhodophsins. But the book is really worth reading for its clinical and behavioral insight.